Differences among a modern cohort of BRCA mutation carriers choosing bilateral prophylactic mastectomies compared to breast surveillance Journal Article
| Authors: | Gilbert, E.; Zabor, E. C.; Stempel, M.; Mangino, D.; Heerdt, A.; Pilewskie, M. |
| Article Title: | Differences among a modern cohort of BRCA mutation carriers choosing bilateral prophylactic mastectomies compared to breast surveillance |
| Abstract: | Background: Women with a BRCA mutation have significantly elevated breast cancer risk, which can be reduced by >90% with bilateral prophylactic mastectomy (BPM). We sought to compare a cohort of BRCA mutation carriers choosing BPM versus breast surveillance to better elucidate factors that may impact decision making. Methods: Women with a BRCA mutation were retrospectively identified from a prospectively maintained database. The surveillance cohort (n = 313) consisted of women seen in a high-risk clinic between 2014 and 2016, while the surgery cohort (n = 142) consisted of women who underwent BPM between 2010 and 2016. Clinical and familial factors were compared between the groups. Results: Women choosing BPM were more likely to have a BRCA1 than BRCA2 mutation compared with the surveillance group (57 vs. 45%, p = 0.02) and were less likely to have a personal history of ovarian cancer (10 vs. 20%, p = 0.01). Furthermore, women undergoing BPM were more likely to be married (78 vs. 62%, p = 0.01), to have more children (median 2 vs. 1, p < 0.001), and to have undergone a prophylactic oophorectomy (61 vs. 37%, p < 0.001). Women choosing BPM had more first-degree relatives (63 vs. 48%, p = 0.01) or a sister (23 vs. 14%, p = 0.02) with a history of breast cancer and were more likely to have a family member with ovarian cancer under the age of 40 years (9 vs. 4%, p = 0.03). There was no difference in the number of prior breast biopsies or history of atypia/lobular carcinoma in situ. Conclusion: The decision to undergo BPM appears multifactorial, with gene mutation, family history, and relationships appearing to have the strongest influence on decision making. © 2017, Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 24 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2017-10-01 |
| Start Page: | 3048 |
| End Page: | 3054 |
| Language: | English |
| DOI: | 10.1245/s10434-017-5976-2 |
| PROVIDER: | scopus |
| PUBMED: | 28766223 |
| PMCID: | PMC5802967 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 October 2017 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work